Published online April 21, 2008
PEDIATRICS Vol. 121 No. 5 May 2008, pp. e1348-e1351 (doi:10.1542/peds.2007-2215)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Google Scholar
Right arrow Articles by Özkan, H.
Right arrow Articles by Duman, N.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Özkan, H.
Right arrow Articles by Duman, N.
Related Collections
Right arrow Premature & Newborn

ARTICLE

Erythroid Apoptosis in Idiopathic Neonatal Jaundice

Hasan Özkan, MDa, Hale Ören, MDb, Mansur Tatli, MDa, Halil Ates, MScc, Abdullah Kumral, MDa and Nuray Duman, MDa

a Departments of Pediatric Neonatology
b Pediatric Hematology
c Hematology Laboratory, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey

OBJECTIVES. The objectives of this study were to evaluate the contribution of erythroid apoptosis to neonatal idiopathic pathologic jaundice and to determine whether a measurement of the erythroid apoptosis value at birth could predict the development of hyperbilirubinemia during the first 15 days of life.

PATIENTS AND METHODS. Three groups were defined: group 1 (n = 101), healthy newborns whose erythroid apoptosis value and serum total bilirubin levels were detected from birth to day 15; group 2 (n = 24), newborns who were hospitalized for jaundice (serum total bilirubin level: >12.9 mg/dL) without any identifiable pathologic cause; and group 3 (control group, n = 24), healthy newborns whose serum total bilirubin levels were ≤12.9 mg/dL. Erythroid apoptosis value was assessed by flow cytometry using an annexin-V fluorescein isothiocyanate kit.

RESULTS. In group 1, there was no correlation between the erythroid apoptosis value and serum total bilirubin levels obtained at birth and at the fourth and 15th days of life; the erythrocyte apoptosis value obtained at birth was not significantly different between the neonates whose serum total bilirubin levels were >12.9 and ≤12.9 mg/dL and who had prolonged and nonprolonged jaundice during follow-up. The erythroid apoptosis value differed significantly between the newborns in groups 2 and 3. There was no significant correlation between the erythroid apoptosis value and serum total bilirubin levels of the infants in groups 2 and 3.

CONCLUSIONS. The erythroid apoptosis value obtained at birth could not predict the development of hyperbilirubinemia in neonates, but it was increased significantly in jaundiced neonates whose serum total bilirubin levels were >12.9 mg/dL. In these infants, increase in the erythroid apoptosis value may be a result of the toxic effect of bilirubin or of a protective mechanism of neonates to increase heme turnover and bilirubin production to diminish oxidative stress.

Key Words: apoptosis • erythrocyte • jaundice • hyperbilirubinemia • newborn

Abbreviations: STB—serum total bilirubin

Accepted Nov 8, 2007.